Workers Compensation Claims Specialist, Complex & Settlement Focus

CNA Insurance; Chicago (IL); Hybrid; USD 54,000 - 103,000; Full time

Job summary

CNA Insurance is seeking an Individual Contributor to manage commercial claims within the Workers’ Compensation line of business. The role involves investigating, resolving, and settling claims with guidance, while maintaining regulatory compliance and high service levels.

Qualified candidates will have a four-year track record in claim handling, a Bachelor's degree or equivalent, and an active Insurance Adjuster License (or ability to obtain within 90 days). Hybrid work options may apply.

Qualifications

• Bachelor's degree or equivalent experience required; four years of relevant claims handling experience preferred.
• Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire where applicable.
• Professional designations (e.g., CPCU) a plus.

Responsibilities

• Manages moderate to high complexity commercial claims within authority and company protocols.
• Investigates and resolves claims with timely updates to insureds and claimants.
• Verifies coverage and estimates reserves per policy language and guidance.
• Gathers information, statements, and documents to determine compensability and damages.
• Maintains relationships with internal and external partners to resolve claims efficiently.
• Maintains regulatory compliance and adheres to quality standards.

Skills

Commercial claims knowledge

Communication skills

Investigation skills

Time management

Analytical thinking

Microsoft Office

Regulatory knowledge

Education

Bachelor's degree or equivalent

Insurance Adjuster License

Tools

Microsoft Office Suite

Job description

About the Role

Job Description Summary This individual contributor position works under moderate direction, and within defined authority limits, to manage and handle commercial claims with moderate to high complexity and exposure for the Worker’s Compensation line of business. Responsibilities include investigating and resolving claims according to company protocols, quality, and customer service standards as well as California Stipulated and management of Future Medical claims. Demonstrates a proactive approach to identifying and advancing settlement opportunities. Position requires regular communication with customers and insureds and may be dedicated to specific account(s).

Essential Duties & Responsibilities

• Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
• Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information.
• Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols.
• Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
• Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims.
• Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.
• Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service.
• Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation.
• Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.
• Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
• May serve as a mentor/coach to less experienced claim professionals.
• May perform additional duties as assigned.

Reporting Relationship

Typically Manager or above

Skills, Knowledge & Abilities

• Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
• Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed.
• Demonstrated ability to develop collaborative business relationships with internal and external work partners.
• Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions.
• Demonstrated investigative experience with an analytical mindset and critical thinking skills.
• Strong work ethic, with demonstrated time management and organizational skills.
• Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity.
• Developing ability to negotiate low to moderately complex settlements.
• Adaptable to a changing environment.
• Knowledge of Microsoft Office Suite and ability to learn business-related software.
• Demonstrated ability to value diverse opinions and ideas.

Education & Experience

Bachelor's Degree or equivalent experience. Typically a minimum four years of relevant experience, preferably in claim handling. Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience. Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. Professional designations are a plus (e.g. CPCU) #LI-AR1 #LI-Hybrid

Salary

In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $54,000 to $103,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location.

Benefits

CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA’s benefits, please visit cnabenefits.com.

Recruitment Technology

CNA utilizes AI-enabled technology during the recruiting process.

Accommodations

CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process.

Company Culture

We are committed to advancing a culture of inclusion – one that attracts talent from all walks of life, fosters respect and collaboration, and enables all of our colleagues to do their best work.

We have a long standing commitment to the diverse communities in which we live and work. We actively make a difference for the greater good through partnerships, sustainability, initiatives, and working together for a better tomorrow.

Corporate Social Responsibility is not one person, or one department, it's the entire enterprise coming together to make the world a better place.